Social support and its correlation with loneliness: a cross-cultural study of Nepalese older adults

The aim of this study was to analyze the situation of social support exchange among elderly men and women and to study the cross-cultural validity of predictors of loneliness in two Nepalese castes/ethnicities of older adults. Data for this study were taken from a cross-sectional study of the elderly at least 60 years old living in one ward of Kathmandu City, conducted in 2005. Loneliness was measured using a three-item loneliness scale based on the University of California at Los Angeles (UCLA) Loneliness Scale. Sources of social support were classified as spouse, children living with their elders, children living apart, and friends/neighbors. Study findings indicate that the main social support exchange for the elderly was with adult children living together, spouse, and friends/neighbors. Results also show gender difference in social support. Significant variables of loneliness were social support received from spouse, social support provided to spouse, and children living together with both elderly parents. This finding shows there is a high degree of cross-cultural invariance in the predictor sources of social support on loneliness among two Nepalese castes/ethnicities older adults.     

Effects of a program to prevent social isolation on loneliness, depression, and subjective well-being of older adults: A randomized trial among older migrants in Japan

Social isolation among the elderly is a concern in developed countries. Using a randomized trial, this study examined the effect of a social isolation prevention program on loneliness, depression, and subjective well-being of the elderly in Japan. Among the elderly people who relocated to suburban Tokyo, 63 who responded to a pre-test were randomized and assessed 1 and 6 months after the program. Four sessions of a group-based program were designed to prevent social isolation by improving community knowledge and networking with other participants and community "gatekeepers." The Life Satisfaction Index A (LSI-A), Geriatric Depression Scale (GDS), Ando-Osada-Kodama (AOK) loneliness scale, social support, and other variables were used as outcomes of this study. A linear mixed model was used to compare 20 of the 21 people in the intervention group to 40 of the 42 in the control group, and showed that the intervention program had a significant positive effect on LSI-A, social support, and familiarity with services scores and a significant negative effect on AOK over the study period. The program had no significant effect on depression. The findings of this study suggest that programs aimed at preventing social isolation are effective when they utilize existing community resources, are tailor-made based on the specific needs of the individual, and target people who can share similar experiences.     

Profile of ethnicity,living arrangements and loneliness amongst older adults in Aotearoa New Zealand: A national cross‐sectional study

Objective

To explore the patterns of living arrangements, ethnicity and loneliness amongst older adults (aged 65+ years) living at home.

Methods

National interRAI‐HC (International Residential Assessment Instrument‐Home Care) assessments conducted between 1 September 2012 and 31 January 2016 were analysed. Analysis focused on the associations between loneliness and both ethnic groups and living arrangements.

Results

There were 71 859 eligible participants, with average age 82.7 years, comprising Māori (5%), Pasifika (3%), Asian (2%) and European/Other (89%) ethnic identification. Most stated that they were not lonely (79%), but those living alone were more likely to be lonely (29%) than those living with others (14%) (P < 0.05). Amongst those living alone, significant differences in the likelihood of being lonely emerged between ethnic groups (P < 0.05).

Conclusions

Ethnic identification and living arrangements were significantly associated with the likelihood of loneliness for those having an interRAI‐HC assessment. Efforts to reduce the negative impacts of loneliness need a nuanced approach.     

Association of polypharmacy with occurrence of loneliness and social isolation among older adults

BackgroundPolypharmacy is increasing. The longitudinal association of polypharmacy and social isolation has not been previously reported. The aim of this study was to explore longitudinal associations of polypharmacy with loneliness and social isolation among older adults.MethodsParticipants aged 60 years and above in southern Sweden were invited for participation. A total of 1526 and 2556 participants were included in the separate analyses for loneliness and social isolation. Polypharmacy was defined as taking five or more medications. Associations of polypharmacy with occurrence of loneliness and social isolation were estimated using logistic regression models.ResultsDuring follow-up, 409 and 414 participants developed loneliness and social isolation, respectively. The odds for loneliness occurrence were higher for participants with polypharmacy compared to participants without polypharmacy (OR, 1.37; 95% CI, 1.05–1.78; P = 0.020). For participants without polypharmacy, the probability of developing loneliness was 0.28 (95% CI, 0.25–0.31), while for those with polypharmacy this probability was 25% higher (0.35; 95% CI, 0.30–0.39). The odds for social isolation occurrence were higher for participants with polypharmacy compared to participants without polypharmacy (OR, 1.29; 95% CI, 1.02–1.64; P = 0.036). For participants without polypharmacy, the probability of developing social isolation was 0.16 (95% CI, 0.14–0.18), while for those with polypharmacy this probability was 18% higher (0.19; 95% CI, 0.17–0.22).ConclusionsPolypharmacy was associated with loneliness and social isolation occurrence among older adults. Consideration of loneliness and social isolation are warranted when caring for older adults taking multiple medications.     

Relationship of activity and social support to the functional health of older adults

OBJECTIVES: According to J. W. Rowe and R. L. Kahn (1997), successful aging is the combination of low probability of disease, high functioning, and active engagement with life. The purpose of this study was to assess the relationship between active engagement with life and functioning in a convenience sample of community-dwelling adults aged 65 and older. METHODS: In this cross-sectional study, 244 members of an organization for older adults were mailed a survey containing the Activity Checklist and the Social Support Inventory as measures of engagement with life and the SF-12 Health Survey as a measure of functioning. RESULTS: Hierarchical linear regression showed that maintenance of instrumental, social, and high-demand leisure activities was associated with higher physical health scores and maintenance of low-demand leisure activities was associated with lower physical health scores. Maintenance of low-demand leisure activities was associated with higher mental health scores. DISCUSSION: If changes in potentially modifiable risk factors such as activity are associated with the beginning of functional decline, early intervention may be possible before disability ensues, thus reducing the risk of disability and ultimately health care costs.     

Social support and loneliness among frail older adults attending daycare centers: A multicultural study in Israel

AimsTo examine the link between intensity of use of formal support and loneliness among older adults, controlling for family support and covariates; and examine the moderating effect of contact frequency with family on this relationship.MethodsCross-sectional data were collected from September 2016 - April 2017 through structured interviews with 360 older adults attending adult day care centers (ADCCs) and representing three different ethnic groups in Israel. Loneliness was assessed by the UCLA Loneliness Scale. Hierarchical regression was applied to the study variables with loneliness scores as dependent variable, and bootstrapping with resampling strategies tested a moderating effect.ResultsLoneliness was linked negatively with contact frequency with the family network, frequency of ADCC attendance, and greater involvement in social activities at the ADCC. Significant negative correlation between ADCC attendance frequency and loneliness occurred only when family contact was at low-to-average frequency, but not in cases of high-contact frequency.ConclusionsFrequent use of ADCCs emerged as a significant contributor beyond the contribution of family support for reducing loneliness in older age, particularly for those with insufficient family contact. Service providers should improve the accessibility and availability of formal community services for the older population.     

Vitamin D deficiency amongst minority ethnic groups in the UK: a cross sectional study

Background

Vitamin D deficiency is common amongst minority groups in Britain but its magnitude amongst South Asian (SA) and Black African-Caribbean (AC) groups is not well defined. The steroidal, endocrine nature of vitamin D provides it with a putative link with cardiovascular disease (CVD), and we hypothesised that aberrant levels of this hormone would reflect a heightened risk of CVD in these ethnic groups.

Methods

SA (n = 1105, 57% male) and AC (n = 748, 51% male) were recruited as part of a community heart failure study from 20 primary care practices, Birmingham, UK. Vitamin D₂/D₃ levels were measured to determine rates of total vitamin D status, which were age/sex adjusted.

Results

The majority of SAs had severe vitamin D deficiency (42.2%, 95% CI: 39.2–45.1), which was more frequent than in AC (12.5%, 10.2–14.9, p < 0.001. Vitamin status in SA and AC was unrelated to the presence of osteoporosis, and on multivariate analysis of SA, vitamin D levels were independently associated with age (β = 0.18, p < 0.001), haemoglobin (β = 0.12, p = 0.002), and negatively with alkaline phosphatase (a marker of bone mineralisation, β = − 0.11, p = 0.022). Amongst AC, vitamin D was independently associated with having ever smoked (β = − 0.13, p = 0.006) and systolic blood pressure (β = 0.10, p = 0.038).

Conclusions

Vitamin D deficiency is a frequent biochemical observation amongst minority groups in Britain but the clinical significance is unclear, and ethnically specific. A proportionate susceptibility to bone disease is not apparent in either minority group.     

An examination of the relationship between passion and subjective well-being in older adults

Activity engagement has long been linked to improved subjective well-being (SWB) in old age. However, recent studies testing Vallerand et al.'s (2003) Dualistic Model of Passion suggest that the type of passionate activity that underlies activity engagement might influence the extent to which individuals benefit from an active lifestyle. In the present article we examined the relationship between harmonious and obsessive passionate activities and subjective well-being in older adults. Results showed that harmonious passion, through its influence on positive affect experienced during activity engagement, is associated with increases in SWB, whereas obsessive passion is associated with decreases in SWB. Engagement in passionate activities might be beneficial for older adults when a passionate activity is harmonious, but detrimental when a passionate activity is obsessive.     

积极老化的影响因素及其与主观幸福感的关系

目的探讨积极老化的影响因素及其与主观幸福感关系。方法采用积极老化量表和中国城市居民主观幸福感量表对165位社区老年人进行调查。结果社区老人积极老化程度在家庭、经济、参与和健康四个维度上并不均衡,且主观幸福感与积极老化中的经济、健康和家庭三个子维度显著正相关(P0.01,P0.001),而与参与维度相关不显著(P0.05)。结论积极老化和老年人主观幸福感两个概念并不完全重叠。     

Social network, social support, and loneliness in older persons with different chronic diseases

OBJECTIVES. This study examines whether patterns of social network size, functional social support, and loneliness are different for older persons with different types of chronic diseases. METHODS. In a community-based sample of 2,788 men and women age 55 to 85 years participating in the Longitudinal Aging Study Amsterdam, chronic diseases status, social network size, support exchanges, and loneliness were assessed. RESULTS. Social network size and emotional support exchanges were not associated with disease status. The only differences between healthy and chronically ill people were found for receipt of instrumental support and loneliness. Disease characteristics played a differential role: greater feelings of loneliness were mainly found for persons with lung disease or arthritis, and receiving more instrumental support was mainly found for persons with arthritis or stroke. DISCUSSION. The specifics of a disease appear to play a (small) role in the receipt of instrumental support and feelings of loneliness of chronically ill older persons.     

Onset of loneliness in older adults: results of a 28?year prospective study

The goal of this research is to test whether often observed correlates of loneliness in older age are related to onset of loneliness longitudinally. Despite the increasing number of longitudinal studies, the investigation of factors that are related to onset of loneliness is still limited. Analyses are based on data of the TamELSA study, which is a population-based prospective study in Tampere, Finland and started in 1979. For the present study 469 older adults aged between 60 and 86 years at baseline, who were not lonely at baseline, were selected and followed-up in 1989, 1999 and 2006. During the 28 years of follow-up approximately one third (N = 178) of the study population developed feelings of loneliness. Logistic regression analyses indicated that losing a partner, reduced social activities, increased physical disabilities, increased feelings of low mood, uselessness and nervousness, rather than baseline characteristics, are related to enhanced feelings of loneliness at follow-up. The higher incidence of loneliness among women can be fully explained by the unequal distribution of risk factors among men and women (e.g., women more often become widowed). Our results are in line with the cognitive approach that conceptualizes loneliness as an unpleasant feeling due to a perceived discrepancy between the desired and the achieved level of social and personal resources.     

Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

Background

Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people.

Methods

This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults), with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness.

Results

The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004). The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35), perceived fatigue (OR = 1.93; 95% CI 1.21-3.10), recurring falls (OR = 2.01; 95% CI 1.11-3.62) and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29). The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727) (p< 0.001).

Conclusions

The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our findings demonstrate the need to expand the design in future studies, aiming to estimate risk and identify possible causal relations.     

Income inequalities,social support and depressive symptoms among older adults in Europe: a multilevel cross-sectional study

This study analysed the association between income inequality and depression from a multilevel perspective among older adults in Europe, including an examination of the role of social support. The data came from Eurostat’s European Health Interview Survey (EHIS). Selected participants were aged 65 years or above (n?=?68,417) and located in 24 European countries. The outcome variable (depression) was measured using the eight-item Patient Health Questionnaire (PHQ-8). The resulting dataset included individual-level (level-1) and aggregate-level (level 2) exposure variables. Level-1 included income quintiles and social support as exposure variables and sex, age, living alone, limitation in activities of daily living and general activity limitation as control variables. Level 2 included the Gini coefficient, healthcare expenditure and dependency ratio. A multilevel linear regression analysis was performed with maximum likelihood (ML) estimation. All the income quintiles from 1 to 4 showed higher average scores for depression than quintile 5 (the highest). Higher social support scores were associated with lower scores for depression. An interaction was found between income quintile and social support, with higher levels of social support associated with lower scores for depression in quintiles 1 and 2. Higher Gini coefficient scores were associated with higher scores for depression. A significative random slope for social support was also found, meaning that the relationship between social support and depression differed across countries. No significant interaction was found between the Gini coefficient and social support. The study findings suggest that more unequal societies provide a less favourable context for the mental health of older adults. There are also significant country-dependent differences in terms of the relationship between support and mental health among older adults.

     

Reducing loneliness in older adults: looking at locals and migrants in a Swiss case study

Older adults are at a high risk for loneliness, and community-based interventions can help reduce loneliness for all older adults in a community, regardless of their migration status. However, little research has investigated how older adults, including locals and migrants (in this case, internal newcomers and international expats) participate in these interventions. The “Neighbourhoods in Solidarity” (NS) are a series of community-based interventions that aim to increase social connectedness and reduce loneliness in older adults (55+) in the canton of Vaud, Switzerland. This longitudinal embedded mixed-methods study aimed to understand whether older adults (distinguishing between locals, newcomers, and expats) were aware of and participated in the NS, to assess whether participation was associated with changes in loneliness, and to identify relevant processes that could explain a reduction in loneliness. We combined a longitudinal pre/post survey (235 respondents) with ethnographic observations and informal interviews. Quantitative findings showed that individuals who participated in the NS did not have significant changes in loneliness. Qualitative findings showed that perceived migration played an important role in who participated, and that the community distinguished between two types of migrants: newcomers who spoke French fluently, and expats who did not. Individuals were only ‘local’ if they had ancestors from the town. Some newcomers and some locals used the NS as a platform to build a new sense of community within the NS, whereas expats rarely participated. This was due to linguistic and cultural determinants, institutional constraints, interpersonal relationships, and personal preferences.     

Patterns of social participation among older adults with disabilities and the relationship with well-being: A latent class analysis

AimLiving with a chronic condition or a disability at older age impacts social participation. Social connections and social activities seem interrelated leading to heterogeneous patterns in social participation. The aim of this study was to identify a typology in social participation among older adults with disabilities, and to relate this typology to their background characteristics and well-being measures.MethodsA total of 1775 older adults with disabilities or chronic conditions aged 65–97 were sampled from a nationwide panel study in the Netherlands. Social participation was assessed by various measures related to social connections, social informal activities, voluntary work, effort to increase social participation, and online social participation. A latent class analysis was carried out to identify a typology of social participation. Differences between these classes were explored with multinomial regression analyses and pairwise comparisons.ResultsFour classes were found: social withdrawers (22.5%, n = 399), proximate social dwellers (14.5%, n = 257), moderately active social dwellers (37.2%, n = 660) and pro-active social dwellers (25.9%, n = 459). Background characteristics, such as living alone and severity of disability, differed significantly among classes. Regarding well-being measures, it appeared that pro-active social dwellers had the most positive scores. Social withdrawers were most prone to reduced life satisfaction and health related quality of life and increased loneliness and experienced participation restrictions.ConclusionsA typology with four patterns based on a wide spectrum of social participation aspects in older adults with disabilities was identified. This typology may help to assess the risk for reduced well-being of older adults with disabilities.